Differential associations of cataracts with somatic and cognitive-affective symptoms of depression: longitudinal findings from the English Longitudinal Study of Ageing.
Cataracts are independently associated with increased risk of incident depressive symptoms in older adults, particularly somatic manifestations, suggesting that timely cataract treatment may represent a potential intervention point for mitigating depressive symptoms in aging populations.
Key Findings
Results
Baseline cataract was significantly associated with an increased risk of overall incident depression in older adults.
OR 1.55, 95% CI 1.13-2.12; P = 0.007 in the fully adjusted model
This association survived the Bonferroni-corrected threshold (P < 0.0167)
Data from 4,584 participants from the English Longitudinal Study of Ageing (ELSA)
581 participants (12.7%) developed incident depressive symptoms
Cataract exposure was self-reported at wave 2, with incident depressive symptoms assessed at wave 4 using the CES-D-8 (cutoff ≥ 3)
Results
Cataracts were significantly associated with somatic symptoms of depression but not with cognitive-affective symptoms.
Cataract was associated with increased odds of somatic symptoms (OR 1.48, 95% CI 1.07-2.03; P = 0.018)
The association with cognitive-affective symptoms was not significant (OR 1.18, 95% CI 0.79-1.77; P = 0.420)
Domain-specific analyses differentiated between somatic and cognitive-affective depression symptom domains
Multivariable logistic regression models were adjusted sequentially for sociodemographics, health behaviors, and comorbidities
Results
Item-level analyses identified specific depressive manifestations nominally associated with cataracts, though these did not survive strict multiple testing correction.
Specific items reaching nominal significance included 'could not enjoy life', 'restless sleep', and 'could not get going'
None of these item-level associations survived strict multiple testing correction
Analyses included sensitivity analyses (stratification, interaction tests) and multiple imputation for missing data
Methods
The study used multiple imputation to handle missing data, resulting in a final analytic cohort of 4,584 participants.
After multiple imputation, the cohort comprised 4,584 participants
Cataract exposure was self-reported at wave 2 of ELSA
Incident depressive symptoms were assessed at wave 4 using the CES-D-8 with a cutoff score of ≥ 3
Sensitivity analyses included stratification and interaction tests
Tu S. (2026). Differential associations of cataracts with somatic and cognitive-affective symptoms of depression: longitudinal findings from the English Longitudinal Study of Ageing.. International ophthalmology. https://doi.org/10.1007/s10792-026-04046-2